Tag Archives: The Centers for Disease Control and Prevention

Chelation treatment for autism might be harmful

2 Dec

In Autism and children of color, moi said:

The number of children with autism appears to be growing. The Centers for Disease Control and Prevention provides statistics on the number of children with autism in the section Data and Statistics:

Prevalence

  • It is estimated that between 1 in 80 and 1 in 240 with an average of 1 in 110 children in the United States have an ASD. [Read article

  • ASDs are reported to occur in all racial, ethnic, and socioeconomic groups, yet are on average 4 to 5 times more likely to occur in boys than in girls.  However, we need more information on some less studied populations and regions around the world. [Read article]

  • Studies in Asia, Europe, and North America have identified individuals with an ASD with an approximate prevalence of 0.6% to over 1%. A recent study in South Korea reported a prevalence of 2.6%. [Data table Adobe PDF file]

  • Approximately 13% of children have a developmental disability, ranging from mild disabilities such as speech and language impairments to serious developmental disabilities, such as intellectual disabilities, cerebral palsy, and autism.  [Read articleExternal Web Site Icon]

Learn more about prevalence of ASDs »

Learn more about the ADDM Project »

Learn more about the MADDSP Project »

On this Page

http://www.cdc.gov/ncbddd/autism/data.html

In order for children with autism to reach their full potential there must be early diagnosis and treatment. https://drwilda.com/2012/03/27/autism-and-children-of-color/

Science Daily is reporting in the article, Controversial Treatment for Autism May Do More Harm Than Good, Researchers Find:

A controversial treatment for autism spectrum disorder (ASD) is not only ineffective but may be harmful, according to a study conducted by Baylor University researchers. The treatment, known as chelation, attempts to eliminate metals such as mercury from the body.

“The chemical substances used in chelation treatment have a myriad of potentially serious side effects such as fever, vomiting, hypertension, hypotension, cardiac arrhythmias and hypocalcemia, which can cause cardiac arrest,” said Tonya N. Davis, Ph.D., assistant professor of educational psychology in Baylor’s School of Education and co-author of the study.

In one example mentioned in the research, “a 5-year-old with ASD died from cardiac arrest caused by hypocalcemia while receiving intravenous chelation.” And, a 2008 clinical study of chelation treatment for autism was suspended due to potential safety risks associated with chelation.

“Chelation therapy represents the ‘cart before the horse’ scenario where the hypothesis supporting the use of chelation was not validated prior to using it as a form of treatment. Evidence does not support the hypothesis that ASD symptoms are associated with specific levels of metals in the body,” said Davis, supervisor of the Applied Behavior Analysis Program at the Baylor Autism Resource Center.

In the study, Davis and colleagues reviewed the research findings of five published studies on chelation. In the studies, 82 participants ages 3 to 14 received chelation treatment ranging from one to seven months. http://www.sciencedaily.com/releases/2012/11/121129162152.htm#.ULhaUfTdQhk.email

Here is the press release from Baylor University:

Controversial Treatment for Autism May Do More Harm Than Good, Baylor University Researchers Find

Nov. 29, 2012

Follow us on Twitter:@BaylorUMediaCom

Contact: Tonya B. Lewis, (254) 710-4656

WACO, Texas (Nov. 29, 2012) –A controversial treatment for autism spectrum disorder (ASD) is not only ineffective but may be harmful, according to a study conducted by Baylor University researchers.

The treatment, known as chelation, attempts to eliminate metals such as mercury from the body.

“The chemical substances used in chelation treatment have a myriad of potentially serious side effects such as fever, vomiting, hypertension, hypotension, cardiac arrhythmias and hypocalcemia, which can cause cardiac arrest,” said Tonya N. Davis, Ph.D., assistant professor of educational psychology in Baylor’s School of Education and co-author of the study. To view the study, published in Research in Autism Spectrum Disorders, visit http://www.sciencedirect.com/science/article/pii/S1750946712000724.

In one example mentioned in the research, “a 5-year-old with ASD died from cardiac arrest caused by hypocalcemia while receiving intravenous chelation.” And, a 2008 clinical study of chelation treatment for autism was suspended due to potential safety risks associated with chelation.

“Chelation therapy represents the ‘cart before the horse’ scenario where the hypothesis supporting the use of chelation was not validated prior to using it as a form of treatment. Evidence does not support the hypothesis that ASD symptoms are associated with specific levels of metals in the body,” said Davis, supervisor of the Applied Behavior Analysis Program at the Baylor Autism Resource Center.

In the study, Davis and colleagues reviewed the research findings of five published studies on chelation. In the studies, 82 participants ages 3 to 14 received chelation treatment ranging from one to seven months.

Of the five studies, four showed mixed results–some positive and negative outcomes for each of the study participants–and one study showed all positive results. But after closer review, Davis and her research team found “methodological weaknesses” in the studies.

“Several studies used numerous treatments at once in addition to chelation that made it impossible to determine if the positive results could be attributed to chelation alone,” Davis said.

Ultimately, Davis found that the research studies did not support the use of chelation as some have claimed and were “insufficient, which is the lowest level of certainty.”

“The use of chelation to remove metals from the body in order to ameliorate ASD could be seen as unfounded and illogical,” said Davis.

Despite the risks and lack of evidence supporting chelation, in an Internet survey, more than 7 percent of parents said they have tried chelation treatment for their children.

“Other researchers have found that validation of a treatment, or lack thereof, does not appear to have an influence over what treatment parents elect to use. Most parents believe in ‘leaving no stone unturned’ when trying to treat their children with ASD and are willing to try anything they believe might help their child,” Davis said.

Davis and her colleagues hope their findings can help parents make decisions about the course of treatment to undertake for their children.

“My hope is that this research will help parents make informed choices when selecting treatments for their child with ASD. While I understand a parent’s desire to try anything and everything that may help their child, as a researcher, it is difficult to watch a family spend time, money, and resources on interventions that research has found to be ineffective, or worse, potentially dangerous,” Davis said.

Other contributing authors to the study include: Daelynn Copeland and Shanna Attai of Baylor; Mark O’Reilly and Soyeon Kang of The University of Texas at Austin; Russell Lang of Texas State University-San Marcos; Mandy Rispoli of Texas A&M University, Jeff Sigafoos of Victoria University of Wellington, New Zealand; Giulio Lancioni of the University of Bari, Italy, and Austin Mulloy of Virginia Commonwealth University.

ABOUT BAYLOR UNIVERSITY

Baylor University is a private Christian University and a nationally ranked research institution, characterized as having “high research activity” by the Carnegie Foundation for the Advancement of Teaching. The University provides a vibrant campus community for approximately 15,000 students by blending interdisciplinary research with an international reputation for educational excellence and a faculty commitment to teaching and scholarship. Chartered in 1845 by the Republic of Texas through the efforts of Baptist pioneers, Baylor is the oldest continually operating University in Texas. Located in Waco, Baylor welcomes students from all 50 states and more than 80 countries to study a broad range of degrees among its 11 nationally recognized academic divisions. Baylor sponsors 19 varsity athletic teams and is a founding member of the Big 12 Conference.

ABOUT BAYLOR SCHOOL OF EDUCATION

The Baylor School of Education is accredited by the National Council for Accreditation of Teacher Education and consists of four departments: Curriculum and Instruction (preparation for classroom teachers and specialists); Educational Administration (post-graduate preparation for school leadership); Educational Psychology (undergraduate and graduate programs for those who are interested in learning, development, measurement, and exceptionalities); and Health, Human Performance and Recreation (preparing for sport- and health-related careers, athletic training and careers in recreational professions, including churches).The School of Education enrolls more than 1,000 undergraduate students and 300 graduate students, employs 70 faculty, and is one of the few school s in the State of Texas that offers a yearlong teaching internship.

Citation:

Journal Reference:

  1. Tonya N. Davis, Mark O’Reilly, Soyeon Kang, Russell Lang, Mandy Rispoli, Jeff Sigafoos, Giulio Lancioni, Daelynn Copeland, Shanna Attai, Austin Mulloy. Chelation treatment for autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 2013; 7 (1): 49 DOI: 10.1016/j.rasd.2012.06.005

The National Institute of Neurological Disorders and Stroke has an autism fact sheet

A diagnosis of autism can be heartbreaking for families and many cling to any shred of hope that there might be a treatment or a cure. Families have to be careful about the treatments and therapies they seek for their children.

Related:

Autism and children of color                                               https://drwilda.com/tag/children-of-color-with-autism/

Archives of Pediatrics and Adolescent Medicine study: Kids with autism more likely to be bullied                                https://drwilda.com/2012/09/06/archives-of-pediatrics-and-adolescent-medicine-study-kids-with-autism-more-likely-to-be-bullied/

Father’s age may be linked to Autism and Schizophrenia https://drwilda.com/2012/08/26/fathers-age-may-be-linked-to-autism-and-schizophrenia/

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Study: Early stress in girls may be the source of later anxiety

13 Nov

Prolonged stress can have adverse effects on humans. Moi wrote about the Adverse Childhood Experiences Study in Study: Some of the effects of adverse stress do not go away:

Sarah D. Sparks writes in the Education Week article, Research Traces Impacts of Childhood Adversity:

Research from Dr. Shonkoff’s center and from other experts finds that positive stress—the kind that comes from telling a toddler he can’t have a cookie or a teenager that she’s about to take a pop quiz—causes a brief rise in heart rate and stress hormones. A jolt can focus a student’s attention and is generally considered healthy.

Similarly, a child can tolerate stress that is severe but may be relatively short-term—from the death of a loved one, for example—as long as he or she has support….

Toxic’ Recipe

By contrast, so-called “toxic stress” is severe, sustained, and not buffered by supportive relationships.

The same brain flexibility, called plasticity, that makes children open to learning in their early years also makes them particularly vulnerable to damage from the toxic stressors that often accompany poverty: high mobility and homelessness; hunger and food instability; parents who are in jail or absent; domestic violence; drug abuse; and other problems, according to Pat Levitt, a developmental neuroscientist at the University of Southern California and the director of the Keck School of Medicine Center on the Developing Child in Los Angeles…. http://www.edweek.org/ew/articles/2012/11/07/11poverty_ep.h32.html?tkn=QLYF5qldyT3U0BI0xqtD5885mihZIxwbX4qZ&cmp=clp-edweek

Here is information about the Adverse Child Experiences Study. The Centers for Disease Control and Prevention provides access to the peer-reviewed publications resulting from The ACE Study. http://acestudy.org/

https://drwilda.com/2012/11/09/study-some-of-the-effects-of-adverse-stress-do-not-go-away/

Waisman Laboratory for Brain Imaging and Behavior published a study which looks at the effects of stress on girls.

Science Daily is reporting in the article, Early Stress May Sensitize Girls’ Brains for Later Anxiety:

High levels of family stress in infancy are linked to differences in everyday brain function and anxiety in teenage girls, according to new results of a long-running population study by University of Wisconsin-Madison scientists.

The study highlights evidence for a developmental pathway through which early life stress may drive these changes. Here, babies who lived in homes with stressed mothers were more likely to grow into preschoolers with higher levels of cortisol, a stress hormone. In addition, these girls with higher cortisol also showed less communication between brain areas associated with emotion regulation 14 years later. Last, both high cortisol and differences in brain activity predicted higher levels of adolescent anxiety at age 18.

The young men in the study did not show any of these patterns.

“We wanted to understand how stress early in life impacts patterns of brain development which might lead to anxiety and depression,” says first author Dr. Cory Burghy of the Waisman Laboratory for Brain Imaging and Behavior. “Young girls who, as preschoolers, had heightened cortisol levels, go on to show lower brain connectivity in important neural pathways for emotion regulation — and that predicts symptoms of anxiety during adolescence….”

The current paper has its roots back in 1990 and 1991, when 570 children and their families enrolled in the Wisconsin Study of Families and Work (WSFW). All of the children were born in either Madison or Milwaukee. Dr. Marilyn Essex, a UW professor of psychiatry and co-director of the WSFW, said the initial goal was to study the effects of maternity leave, day care and other factors on family stress. Over the years, the study has resulted in important findings on the social, psychological, and biological risk factors for child and adolescent mental health problems. Subjects are now 21 and 22 years old, and many continue to participate.

For the current study, Burghy and Birn used fcMRI to scan the brains of 57 subjects — 28 female and 29 male — to map the strength of connections between the amygdala, an area of the brain known for its sensitivity to negative emotion and threat, and the prefrontal cortex, often associated with helping to process and regulate negative emotion. Then, they looked back at earlier results and found that girls with weaker connections had, as infants, lived in homes where their mothers had reported higher general levels of stress — which could include symptoms of depression, parenting frustration, marital conflict, feeling overwhelmed in their role as a parent, and/or financial stress. As four-year-olds, these girls also showed higher levels of cortisol late in the day, measured in saliva, which is thought to demonstrate the stress the children experienced over the course of that day. http://www.sciencedaily.com/releases/2012/11/121111152930.htm#.UKEogDfvMTo.email

Citation:

Nature Neuroscience | Article

Developmental pathways to amygdala-prefrontal function and internalizing symptoms in adolescence

Nature Neuroscience
(2012)
doi:10.1038/nn.3257
Received
23 July 2012
Accepted
11 October 2012
Published online
11 November 2012
Abstract

Early life stress (ELS) and function of the hypothalamic-pituitary-adrenal axis predict later psychopathology. Animal studies and cross-sectional human studies suggest that this process might operate through amygdala–ventromedial prefrontal cortex (vmPFC) circuitry implicated in the regulation of emotion. Here we prospectively investigated the roles of ELS and childhood basal cortisol amounts in the development of adolescent resting-state functional connectivity (rs-FC), assessed by functional connectivity magnetic resonance imaging (fcMRI), in the amygdala-PFC circuit. In females only, greater ELS predicted increased childhood cortisol levels, which predicted decreased amygdala-vmPFC rs-FC 14 years later. For females, adolescent amygdala-vmPFC functional connectivity was inversely correlated with concurrent anxiety symptoms but positively associated with depressive symptoms, suggesting differing pathways from childhood cortisol levels function through adolescent amygdala-vmPFC functional connectivity to anxiety and depression. These data highlight that, for females, the effects of ELS and early HPA-axis function may be detected much later in the intrinsic processing of emotion-related brain circuits.

Stress has negative effects on the body.

According to the Mayo Clinic article, Stress symptoms: Effects on your body, feelings and behavior:

Common effects of stress …
… On your body … On your mood … On your behavior
  • Headache
  • Muscle tension or pain
  • Chest pain
  • Fatigue
  • Change in sex drive
  • Stomach upset
  • Sleep problems
  • Anxiety
  • Restlessness
  • Lack of motivation or focus
  • Irritability or anger
  • Sadness or depression
  • Overeating or undereating
  • Angry outbursts
  • Drug or alcohol abuse
  • Tobacco use
  • Social withdrawal

Source: American Psychological Association’s “Stress in America” report, 2010

http://www.mayoclinic.com/health/stress-symptoms/SR00008_D

This study points to the need for quality prenatal care.

The March of Dimes discusses stress during pregnancy in the article, Emotional and life changes:

What types of stress can cause pregnancy problems?

Stress is not all bad. When you handle it right, a little stress can help you take on new challenges. Regular stress during pregnancy, such as work deadlines and sitting in traffic, probably don’t add to pregnancy problems.

However, serious types of stress during pregnancy may increase your chances of certain problems, like premature birth. Most women who have serious stress during pregnancy can have healthy babies. But be careful if you experience serious kinds of stress, like:

  • Negative life events. These are things like divorce, serious illness or death in the family, or losing a job or home. 
  • Catastrophic events. These are things like earthquakes, hurricanes or terrorist attacks. 
  • Long-lasting stress. This type of stress can be caused by having financial problems, being abused, having serious health problems or being depressed. Depression is medical condition where strong feelings of sadness last for long periods of time and prevent a person from leading a normal life. 
  • Racism. Some women may face stress from racism during their lives. This may help explain why African-American women in the United States are more likely to have premature and low-birthweight babies than women from other racial or ethnic groups. 
  • Pregnancy-related stress. Some women may feel serious stress about pregnancy. They may be worried about miscarriage, the health of their baby or about how they’ll cope with labor and birth or becoming a parent. If you feel this way, talk to your health care provider.

Does post-traumatic stress disorder affect pregnancy?
Post-traumatic stress disorder (PTSD) is when you have problems after seeing or experiencing a terrible event, such as rape, abuse, a natural disaster, a terrorist attack or the death of a loved one. People with PTSD may have:

  • Serious anxiety 
  • Flashbacks of the event 
  • Nightmares 
  • Physical responses (like a racing heartbeat or sweating) when reminded of the event

As many as 8 in 100 women (8 percent) may have PTSD during pregnancy. Women who have PTSD may be more likely than women without it to have a premature or low-birthweight baby. They also are more likely than other women to have risky health behaviors, such as smoking cigarettes, drinking alcohol or taking street drugs. Doing these things can increase the chances of having pregnancy problems. If you think you may have PTSD, talk to your provider or a mental health professional.

How does stress cause pregnancy problems?
We don’t completely understand the effects of stress on pregnancy. But certain stress-related hormones may play a role in causing certain pregnancy complications. Serious or long-lasting stress may affect your immune system, which protects you from infection. This can increase the chances of getting an infection of the uterus. This type of infection can cause premature birth.

Stress also may affect how you respond to certain situations. Some women deal with stress by smoking cigarettes, drinking alcohol or taking street drugs, which can lead to pregnancy problems.

Can high levels of stress in pregnancy hurt your baby later in life?
Some studies show that high levels of stress in pregnancy may cause certain problems during childhood, like having trouble paying attention or being afraid. It’s possible that stress may also affect your baby’s brain development or immune system.

How can you reduce stress during pregnancy?
Here are some ways to reduce stress:

  • Figure out what’s making you stressed and talk to your partner, a friend or your health care provider about it. 
  • Know that the discomforts of pregnancy are only temporary. Ask your provider how to handle these discomforts. 
  • Stay healthy and fit. Eat healthy foods, get plenty of sleep and exercise (with your provider’s OK).
  • Exercise can help reduce stress and also helps prevent common pregnancy discomforts. 
  • Cut back on activities you don’t need to do. 
  • Have a good support network, including your partner, family and friends. Ask your provider about resources in the community that may be able to help. 
  • Ask for help from people you trust. Accept help when they offer. For example, you may need help cleaning the house, or you may want someone to go with you to your prenatal visits. 
  • Try relaxation activities, like prenatal yoga or meditation. 
  • Take a childbirth education class so you know what to expect during pregnancy and when your baby arrives. Practice the breathing and relaxation techniques you learn in your class. 
  • If you’re working, plan ahead to help you and your employer get ready for your time away from work. 
  • If you think you may be depressed, talk to your provider right away. There are many ways to deal with depression. Getting treatment and counseling early may help.

Last reviewed January 2012 http://www.marchofdimes.com/pregnancy/lifechanges_indepth.html

See, The Importance of Quality Prenatal Care http://www.mdnews.com/news/2010_07/national_jul10_the-importance-of-quality-prenatal-care

Our goal as a society should be:

A healthy child in a healthy family who attends a healthy school in a healthy neighborhood ©

Resources:

The Effects of Stress on Your Body                                           http://www.webmd.com/mental-health/effects-of-stress-on-your-body

The Physical Effects of Long-Term Stress                              http://psychcentral.com/lib/2007/the-physical-effects-of-long-term-stress/all/1/

Chronic Stress: The Body Connection                            http://www.medicinenet.com/script/main/art.asp?articlekey=53737

Understanding Stress Symptoms, Signs, Causes, and Effects http://www.helpguide.org/mental/stress_signs.htm

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COMMENTS FROM AN OLD FART © http://drwildaoldfart.wordpress.com/

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Johns Hopkins University study: Advertising affects alcohol use by children

11 Aug

Moi discussed alcohol use among teens in Seattle Children’s Institute study: Supportive middle school teachers affect a kid’s alcohol use:

Substance abuse is a serious problem for many young people. The Centers for Disease Control provide statistics about underage drinking in the Fact Sheet: Underage Drinking:

Underage Drinking

Alcohol use by persons under age 21 years is a major public health problem.1 Alcohol is the most commonly used and abused drug among youth in the United States, more than tobacco and illicit drugs. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States.2 More than 90% of this alcohol is consumed in the form of binge drinks.2 On average, underage drinkers consume more drinks per drinking occasion than adult drinkers.3 In 2008, there were approximately 190,000 emergency rooms visits by persons under age 21 for injuries and other conditions linked to alcohol.4

Drinking Levels among Youth

The 2009 Youth Risk Behavior Survey5 found that among high school students, during the past 30 days

  • 42% drank some amount of alcohol.

  • 24% binge drank.

  • 10% drove after drinking alcohol.

  • 28% rode with a driver who had been drinking alcohol.

Other national surveys indicate

  • In 2008 the National Survey on Drug Use and HealthExternal Web Site Icon reported that 28% of youth aged 12 to 20 years drink alcohol and 19% reported binge drinking.6

  • In 2009, the Monitoring the Future SurveyExternal Web Site Icon reported that 37% of 8th graders and 72% of 12th graders had tried alcohol, and 15% of 8th graders and 44% of 12th graders drank during the past month.7

Consequences of Underage Drinking

Youth who drink alcohol1, 3, 8 are more likely to experience

  • School problems, such as higher absence and poor or failing grades.

  • Social problems, such as fighting and lack of participation in youth activities.

  • Legal problems, such as arrest for driving or physically hurting someone while drunk.

  • Physical problems, such as hangovers or illnesses.

  • Unwanted, unplanned, and unprotected sexual activity.

  • Disruption of normal growth and sexual development.

  • Physical and sexual assault.

  • Higher risk for suicide and homicide.

  • Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning.

  • Memory problems.

  • Abuse of other drugs.

  • Changes in brain development that may have life-long effects.

  • Death from alcohol poisoning.

In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink.8

Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years.9, 10 http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm

See, Alcohol Use Among Adolescents and Young  Adults http://pubs.niaaa.nih.gov/publications/arh27-1/79-86.htm

https://drwilda.wordpress.com/2012/03/26/seattle-childrens-institute-study-supportive-middle-school-teachers-affect-a-kids-alcohol-use/

A 2006 policy statement in Pediatrics discusses the issues involved in advertising to children.

The American Academy of Pediatrics outlines its policy in Children, Adolescents, and Advertising. Here is an excerpt from the policy:

Abstract

Advertising is a pervasive influence on children and adolescents. Young people view more than 40 000 ads per year on television alone and increasingly are being exposed to advertising on the Internet, in magazines, and in schools. This exposure may contribute significantly to childhood and adolescent obesity, poor nutrition, and cigarette and alcohol use. Media education has been shown to be effective in mitigating some of the negative effects of advertising on children and adolescents. INTRODUCTION
Several European countries forbid or severely curtail advertising to children; in the United States, on the other hand, selling to children is simply “business as usual.”1 The average young person views more than 3000 ads per day on television (TV), on the Internet, on billboards, and in magazines.2 Increasingly, advertisers are targeting younger and younger children in an effort to establish “brand-name preference” at as early an age as possible.3 This targeting occurs because advertising is a $250 billion/year industry with 900 000 brands to sell,2 and children and adolescents are attractive consumers: teenagers spend $155 billion/year, children younger than 12 years spend another $25 billion, and both groups influence perhaps another $200 billion of their parents’ spending per year.4,5 Increasingly, advertisers are seeking to find new and creative ways of targeting young consumers via the Internet, in schools, and even in bathroom stalls.1THE EFFECTS OF ADVERTISING ON CHILDREN AND ADOLESCENTS
Research has shown that young children—younger than 8 years—are cognitively and psychologically defenseless against advertising.69 They do not understand the notion of intent to sell and frequently accept advertising claims at face value.10 In fact, in the late 1970s, the Federal Trade Commission (FTC) held hearings, reviewed the existing research, and came to the conclusion that it was unfair and deceptive to advertise to children younger than 6 years.11 What kept the FTC from banning such ads was that it was thought to be impractical to implement such a ban.11 However, some Western countries have done exactly that: Sweden and Norway forbid all advertising directed at children younger than 12 years, Greece bans toy advertising until after 10 pm, and Denmark and Belgium severely restrict advertising aimed at children.12                                     http://pediatrics.aappublications.org/content/118/6/2563.full

Citation:

Pediatrics Vol. 118 No. 6 December 1, 2006
pp. 2563 -2569
(doi: 10.1542/peds.2006-2698)

  1. AbstractFree

  2. » Full TextFree

  3. Full Text (PDF)Free

Jeanette Mulvey, Business News Daily Managing Editor at LiveScience.com is reporting in the article, How Alcohol Ads Target Kids:

Parents might do their best to shield their kids from advertising related to alcohol, but alcohol marketers are doing their best to reach them anyway. That’s the finding of new research that discovered that the content of alcohol ads placed in magazines is more likely to violate industry guidelines if the ad appears in a magazine with sizable youth readership.

The research, which was done by the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health, found that ads in magazines with a substantial youth readership (15 percent or more) frequently showed alcohol being consumed in an irresponsible manner. Examples include showing alcohol consumption near or on bodies of water, encouraging overconsumption, and providing messages supportive of alcohol addiction. In addition, nearly one in five ad occurrences contained sexual connotations or sexual objectification.

“The bottom line here is that youth are getting hit repeatedly by ads for spirits and beer in magazines geared towards their age demographic,” said CAMY director and study co-author David Jernigan. “As at least 14 studies have found that the more young people are exposed to alcohol advertising and marketing, the more likely they are to drink, or if already drinking, to drink more, this report should serve as a wake-up call to parents and everyone else concerned about the health of young people.”http://news.yahoo.com/alcohol-ads-target-kids-125635247.html?_esi=1

Here is the press release from the Bloomberg School of Health:

For Immediate Release:                                                                                Contact: Tim Parsons
August 8, 2012                                                                                                410-955-6878 or tmparson@jhsph.edu

                  Alcohol Advertising Standards Violations Most Common in Magazines with Youthful Audiences

                              First study to examine the relationship of risky content in alcohol ads to youth exposure

The content of alcohol ads placed in magazines is more likely to be in violation of industry guidelines if the ad appears in a magazine with sizeable youth readership, according to a new study from the Center on Alcohol Marketing and Youth (CAMY) at the Johns Hopkins Bloomberg School of Public Health. Published in the Journal of Adolescent Health, the study is the first to measure the relationship of problematic content to youth exposure, and the first to examine risky behaviors depicted in alcohol advertising in the past decade.

     The researchers examined 1,261 ads for alcopops, beer, spirits or wine that appeared over 2,500 times in 11 different magazines that have or are likely to have disproportionately youthful readerships – that is, youth readerships equaling or exceeding 15 percent. Ads were analyzed for different risk codes: injury content, overconsumption content, addiction content, sex-related content and violation of industry guidelines. This latter category refers to the voluntary codes of good marketing practice administered by alcohol industry trade associations. Examples of code violations include ads appearing to target a primarily underage audience, highlighting the high alcohol content of a product, or portraying alcohol consumption in conjunction with activities requiring a high degree of alertness or coordination such as swimming.

     “The finding that violations of the alcohol industry’s advertising standards were most common in magazines with the most youthful audiences tells us self-regulated voluntary codes are failing,” said CAMY Director and study co-author David Jernigan, PhD. “It’s time to seriously consider stronger limits on youth exposure to alcohol advertising.”

     Specific examples the researchers identified in the sample included advertising showing alcohol consumption near or on bodies of water, encouraging overconsumption, and providing messages supportive of alcohol addiction. In addition, nearly one in five ad occurrences contained sexual connotations or sexual objectification. Results also show ads were concentrated across type of alcohol, brand and outlet, with spirits representing about two-thirds of the sample, followed by ads for beer, which comprised almost another 30 percent. The ten most advertised brands, a list comprised solely of spirits and beer brands, accounted for 30 percent of the sample, and seven brands were responsible for more than half of the violations of industry marketing guidelines.

     “The bottom line here is that youth are getting hit repeatedly by ads for spirits and beer in magazines geared towards their age demographic,” said Jernigan. “As at least 14 studies have found the more young people are exposed to alcohol advertising and marketing, the more likely they are to drink, or if already drinking, to drink more, this report should serve as a wake-up call to parents and everyone else concerned about the health of young people.”

     Alcohol is responsible for 4,700 deaths per year among young people under the age of 21, and is associated with the three leading causes of death among youth: motor vehicle crashes, homicide and suicide.

     The research was funded by grants from the Centers for Disease Control and Prevention to the Johns Hopkins Center for Injury Research and Policy.

    The Center on Alcohol Marketing and Youth monitors the marketing practices of the alcohol industry to focus attention and action on industry practices that jeopardize the health and safety of America’s youth. The Center was founded in 2002 at Georgetown University with funding from The Pew Charitable Trusts and the Robert Wood Johnson Foundation. The Center moved to the Johns Hopkins Bloomberg School of Public Health in 2008 and is currently funded by the federal Centers for Disease Control and Prevention. For more information, visit http://www.camy.org.

###

Additional media contact: Alicia Samuels, MPH, Center on Alcohol Marketing and Youth (CAMY), 914-720-4635 or alsamuel@jhsph.edu.

Assuming you are not one of those ill-advised parents who supply their child with alcohol or drugs like marijuana in an attempt to be hip or cool, suspicions that your child may have a substance abuse problem are a concern. Confirmation that your child has a substance abuse problem can be heartbreaking. Even children whose parents have seemingly done everything right can become involved with drugs. The best defense is knowledge about your child, your child’s friends, and your child’s activities. You need to be aware of what is influencing your child.

Our goal should be:

A Healthy Child In A Healthy Family Who Attends A Healthy School In A Healthy Neighborhood. ©

Related:

More school districts facing a financial crunch are considering school ads https://drwilda.wordpress.com/2012/06/04/more-school-districts-facing-a-financial-crunch-are-considering-school-ads/

Should there be advertising in schools? https://drwilda.wordpress.com/2011/11/10/should-there-be-advertising-in-schools/

Talking to your teen about risky behaviors https://drwilda.wordpress.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

Television cannot substitute for quality childcare https://drwilda.wordpress.com/2012/04/23/television-cannot-substitute-for-quality-childcare/

Dr. Wilda says this about that ©

CDC report: Contraceptive use among teens

24 Jul

In No one is perfect: People sometimes fail, moi said:

There are no perfect people, no one has a perfect life and everyone makes mistakes. Unfortunately, children do not come with instruction manuals, which give specific instructions about how to relate to that particular child. Further, for many situations there is no one and only way to resolve a problem. What people can do is learn from their mistakes and the mistakes of others. Craig Playstead has assembled a top ten list of mistakes made by parents and they should be used as a starting point in thinking about your parenting style and your family’s dynamic. https://drwilda.wordpress.com/2011/12/06/no-one-is-perfect-people-sometimes-fail/ Still, parents must talk to their children about life risks.  https://drwilda.wordpress.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

The Centers for Disease Control (CDC)has published a study about the sexual activity of children.

Here is the press release for the CDC report, Sexual Experience and Contraceptive Use Among Female Teens — United States, 1995, 2002, and 2006–2010:

Sexual Experience and Contraceptive Use Among Female Teens — United States, 1995, 2002, and 2006–2010

Weekly

May 4, 2012 / 61(17);297-301

The 2010 U.S. teen birth rate of 34.3 births per 1,000 females reflected a 44% decline from 1990 (1). Despite this trend, U.S. teen birth rates remain higher than rates in other developed countries; approximately 368,000 births occurred among teens aged 15–19 years in 2010, and marked racial/ethnic disparities persist (1,2). To describe trends in sexual experience and use of contraceptive methods among females aged 15–19 years, CDC analyzed data from the National Survey of Family Growth collected for 1995, 2002, and 2006–2010 (3). During 2006–2010, 57% of females aged 15–19 years had never had sex (defined as vaginal intercourse), an increase from 49% in 1995. Younger teens (aged 15–17 years) were more likely not to have had sex (73%) than older teens (36%); the proportion of teens who had never had sex did not differ by race/ethnicity. Approximately 60% of sexually experienced teens reported current use of highly effective contraceptive methods (e.g., intrauterine device [IUD] or hormonal methods), an increase from 47% in 1995. However, use of highly effective methods varied by race/ethnicity, with higher rates observed for non-Hispanic whites (66%) than non-Hispanic black (46%) and Hispanic teens (54%). Addressing the complex issue of teen childbearing requires a comprehensive approach to sexual and reproductive health that includes continued promotion of delayed sexual debut and increased use of highly effective contraception among sexually experienced teens.

Nationally representative data on females aged 15–19 years were obtained from three survey cycles of the National Survey of Family Growth (NSFG): 1995, 2002, and 2006–2010. NSFG is an in-person, household survey conducted by CDC’s National Center for Health Statistics using a stratified, multistage probability sample of females and males aged 15–44 years. The response rate for females was 76%. Survey topics included self-reported sexual activity and contraceptive use (4). Respondents who answered “yes” to ever having vaginal intercourse were considered sexually experienced.

Respondents who were pregnant, postpartum, seeking pregnancy, or who had not had sex during the interview month were excluded from analyses on contraceptives used during the interview month. The remaining respondents were classified as currently using contraception (specifying up to four methods) or not currently using contraception. Current contraceptive users were classified further by their most effective method used (according to typical use effectiveness estimates for pregnancy prevention) (3), based on the following hierarchy: 1) users of highly effective methods, including respondents who used long-acting reversible contraception (i.e., intrauterine device [IUD] or implant), pill, patch, ring, or injectable contraception (with or without dual use of condoms), or who were sterilized or had a partner who was sterilized (both were rare for teens); 2) users of moderately effective methods, including respondents who used condoms alone; and 3) users of less effective methods, including respondents who used withdrawal, periodic abstinence, rhythm method, emergency contraception, diaphragm, female condom, foam, jelly, cervical cap, sponge, suppository, or insert.

Weighted least squares regression was used to assess the significance of trends in abstinence and contraceptive use over time. Differences in bivariate proportions between racial/ethnic and age subgroups were assessed using a standard two-tailed t-test without adjustment for multiple comparisons. Comparisons are statistically significant at p<0.05. All analyses were conducted using data management and statistical software to account for the complex sample design of the NSFG.

During 2006–2010, more than half (56.7%) of female teens had never had sex (Table), reflecting a 16% increase relative to the 1995 estimate of 48.9%. The proportion of teens who had never had sex did not differ significantly across racial/ethnic groups* (whites = 57.6%, blacks = 53.6%, Hispanics = 56.2%) (Table). Although the proportion of teens who had never had sex increased for all racial/ethnic groups from 1995 to 2006–2010, this increase was greatest for blacks (34% increase) and Hispanics (29% increase) compared with whites (15% increase). During 2006–2010, 72.9% of females aged 15–17 years had never had sex, compared with 36.5% of females aged 18–19 years.

During 2006–2010, among female teens who had sex during the interview month, but who were not pregnant, postpartum, or seeking pregnancy, 59.8% used a highly effective contraceptive method during the interview month (12.0% used a highly effective method with a condom and 47.8% used a highly effective method without a condom), 16.3% used a moderately effective method (i.e., condoms alone), 6.1% used a less effective method, and 17.9% did not use any contraception (Figure). A trend toward increasing use of highly effective methods was noted from 1995 to 2006–2010. Estimates for 2006–2010 reflect a relative 26% increase in use of highly effective methods, 43% decrease for moderately effective methods, 27% increase for less effective methods, and 7% decrease for no method use compared with 1995.

During 2006–2010, white teens (65.7%) reported a higher prevalence of highly effective method use than black teens (46.5%) and Hispanic teens (53.7%) (Figure). Nonuse of any contraceptive method was significantly higher among blacks (25.6%) and Hispanics (23.7%) compared with whites (14.6%). Among whites, the use of highly effective methods increased from 48.9% in 1995 to 65.7% in 2006–2010 (34% relative increase). Smaller increases were observed for Hispanics (19% relative increase) and blacks (4% relative increase). Method nonuse among whites decreased from 18.1% in 1995 to 14.6% in 2006–2010 (19% decline); however, rates increased among blacks from 21.4% in 1995 to 25.6% in 2006–2010 (20% increase). For females aged 15–17 years, the use of highly effective methods increased from 46.0% during 1995 to 56.5% during 2006–2010 (23% increase). For females aged 18–19 years, the use of highly effective methods increased from 48.4% during 1995 to 61.8% during 2006–2010 (28% increase). Rates of nonuse among younger teens declined from 23.9% to 19.5% (19% decline) but remained relatively stable for older teens at 16.3% in 1995 and 16.9% during 2006–2010.

Reported by

Crystal Pirtle Tyler, PhD, Lee Warner, PhD, Joan Marie Kraft, PhD, Alison Spitz, MPH, Lorrie Gavin, PhD, Violanda Grigorescu, MD, Carla White, MPH, Wanda Barfield, MD, Div of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC. Corresponding contributor:Crystal Pirtle Tyler, ctyler@cdc.gov, 770-488-5200.

Editorial Note

In 2010, the U.S. teen birth rate declined to the lowest level in seven decades of reporting and reached record lows for teens of all racial/ethnic and age groups (1). Declines since 1995 likely reflect significant increases in the proportion of female teens who were abstinent, and among sexually experienced female teens, increases in the proportion using highly effective contraception (5).

The proportion of female teens who never have had sex is now comparable across racial/ethnic groups, largely because of proportionately larger increases in delayed sexual debut observed since 1995 among black teens and Hispanic teens compared with white teens. Disparities persist, however, in the use of highly effective methods of contraception. Use of these methods remains highest among white teens, and increases over time have occurred at a greater rate among whites compared with blacks and Hispanics.

Achieving the HealthyPeople 2020 objective† of reducing teen pregnancy by 10% will require a comprehensive approach to sexual and reproductive health that includes continued promotion of delayed sexual debut and increased use of highly effective contraception among sexually experienced teens. Condoms, the method used by many teens, can provide effective protection against unintended pregnancy when used consistently and correctly; however, during 2006–2010, only about half (49%) of female teens who used a condom for contraception reported consistent use in the past month (6). Dual use of condoms with a highly effective method of contraception can provide pregnancy protection with the added benefit of preventing sexually transmitted infections, including infection with human immunodeficiency virus, which affects teens disproportionately. Given that hormonal contraception and IUDs can be obtained only from a health-care provider, yearly reproductive health visits for teens who are sexually experienced or contemplating sexual activity can facilitate discussions about the advantages of delaying sexual debut, access to contraception, and the subsequent reduction of teen pregnancy (7,8).

An analysis of data from CDC’s Pregnancy Risk Assessment Monitoring System on female teens who had delivered a live infant within 2–6 months and reported that their pregnancy was unintended found that half were not using contraception when they got pregnant (9). Ways to reduce barriers to decrease teen pregnancy include encouraging teens to delay sexual debut, offering teens convenient practice hours, culturally competent and confidential counseling and services, and low-cost or free services and methods.

The findings in this report are subject to at least three limitations. First, estimates of contraceptive use are self-reported; however, NSFG was designed specifically to minimize potential sources of response error (4). Second, current use of a contraceptive method during the interview month does not necessarily reflect sustained use over time. Finally, data were not available to examine current sexual activity or contraceptive use among female teens aged <15 years, who accounted for 4,500 births in 2010 (1).

Several actions can be taken to reduce teen pregnancy further. Schools and community- based organizations can 1) provide evidence-based sexual and reproductive health education,§ 2) support parents’ efforts to speak with their children about advantages of delaying sexual debut and of delaying pregnancy, and 3) connect teens to health-care providers for reproductive health services. Health-care providers should be informed that no contraceptive method is contraindicated for teens solely on the basis of age (10) and encouraged to promote highly effective contraception, preferably with the dual use of condoms. Teen pregnancy might be reduced further if health-care professionals provide culturally competent, evidence-based sexual and reproductive health counseling on the importance of correct and consistent use of contraception, and offer an array of contraceptive methods to teens who have had sex or are about to initiate sexual activity.

Acknowledgments

Gladys M. Martinez, PhD, Stephanie J. Ventura, MA, Joyce C. Abma, PhD, Div of Vital Statistics, National Center for Health Statistics; John M. Douglas, Jr, MD, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC.

References

  1. Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data for 2010. Natl Vital Stat Rep 2011;60(2).
  2. United Nations. Demographic yearbook 2009. New York, NY: United Nations; 2010. Available at http://unstats.un.org/unsd/demographic/products/dyb/dyb2.htmExternal Web Site Icon. Accessed February 28, 2012.
  3. Trussell J. Contraceptive failure in the United States. Contraception 2011;83:397–404.
  4. Groves RM, Mosher WD, Lepkowski J, Kirgis NG. Planning and development of he continuous National Survey of Family Growth. Vital Health Stat 2009;1(48).
  5. Santelli JS, Lindberg LD, Finer LB, Singh S. Explaining recent declines in adolescent pregnancy in the United States: the contribution of abstinence and improved contraceptive use. Am J Public Health 2007;97:150–6.
  6. Martinez G, Copen CE, Abma JC. Teenagers in the United States: sexual activity, contraceptive use, and childbearing, 2006–2010 National Survey of Family Growth. Vital Health Stat 2011;23(31).
  7. American College of Obstetricians and Gynecologists, Committee on Adolescent Health. The initial reproductive health visit. Committee opinion no. 460. Obstet Gynecol 2010;116:240–3.
  8. Hagan JF, Shaw JS, Duncan PM. Bright futures: guidelines for health supervision of infants, children and adolescents. 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2008.
  9. CDC. Prepregnancy contraceptive use among teens with unintended pregnancies resulting in live births—Pregnancy Risk Assessment Monitoring System (PRAMS), 2004–2008. MMWR 2012;61:25–9.
  10. CDC. U.S. medical eligibility criteria for contraceptive use, 2010. MMWR 2010;59(No. RR-4).

* Persons identified as Hispanic might be of any race; persons in all other racial/ethnic categories are non-Hispanic.

Objective FP-8, available at http://www.healthypeople.gov/2020/topicsobjectives2020/pdfs/familyplanning.pdf Adobe PDF fileExternal Web Site Icon.

§ The Community Preventive Services Task Force recommends comprehensive risk reduction interventions. Additional information is available at http://www.thecommunityguide.org/news/2012/crrandaeinterventions.htmlExternal Web Site Icon

For a good summary of the report, More teens using condoms over past two decades http://www.wtop.com/267/2955744/US-targets-AIDS-stigma

In Talking to kids about sex, early and often, moi said: 

The blog discussed the impact of careless, uninformed, and/or reckless sex in the post, A baby changes everything: Helping parents finish school http://us.mg5.mail.yahoo.com/2011/12/26/a-baby-changes-everything-helping-parents-finish-school/ Let’s continue the discussion. Some folks may be great friends, homies, girlfriends, and dudes, but they make lousy parents. Could be they are at a point in their life where they are too selfish to think of anyone other than themselves, they could be busy with school, work, or whatever. No matter the reason, they are not ready and should not be parents. Birth control methods are not 100% effective, but the available options are 100% ineffective in people who are sexually active and not using birth control. So, if you are sexually active and you have not paid a visit to Planned Parenthood or some other agency, then you are not only irresponsible, you are Eeeevil. Why do I say that? You are playing “Russian Roulette” with the life of another human being, the child. You should not ever put yourself in the position of bringing a child into the world that you are unprepared to parent, emotionally, financially, and with a commitment of time. So, if you find yourself in a what do I do moment and are pregnant, you should consider adoption. Before reaching that fork in the road of what to do about an unplanned pregnancy, parents must talk to their children about sex and they must explain their values to their children. They must explain why they have those values as well.  https://drwilda.wordpress.com/2012/01/01/talking-to-kids-about-sex-early-and-often/

Related:

Study: Girls as young as six think of themselves as sex objects        https://drwilda.wordpress.com/2012/07/18/study-girls-as-young-as-six-think-of-themselves-as-sex-objects/

Study: Low-income populations and marriage https://drwilda.wordpress.com/2012/07/14/study-low-income-populations-and-marriage/

Title IX also mandates access to education for pregnant students https://drwilda.wordpress.com/2012/06/19/title-ix-also-mandates-access-to-education-for-pregnant-students/

Teaching kids that babies are not delivered by UPS                       https://drwilda.wordpress.com/2012/01/22/teaching-kids-that-babies-are-not-delivered-by-ups/

Talking to your teen about risky behaviors                https://drwilda.wordpress.com/2012/06/07/talking-to-your-teen-about-risky-behaviors/

Dr. Wilda says this about that ©

Autism and children of color

27 Mar

Lauran Neergaard reported in the Huffington Post article, Autism Not Diagnosed As Early In Minority Children: Study:

Her preliminary research suggests even when diagnosed in toddlerhood, minority youngsters have more severe developmental delays than their white counterparts. She says cultural differences in how parents view developmental milestones, and how they interact with doctors, may play a role.

Consider: Tots tend to point before they talk, but pointing is rude in some cultures and may not be missed by a new parent, Landa says. Or maybe mom’s worried that her son isn’t talking yet but the family matriarch, her grandmother, says don’t worry – Cousin Harry spoke late, too, and he’s fine. Or maybe the pediatrician dismissed the parents’ concern, and they were taught not to question doctors.

It’s possible to detect autism as early as 14 months of age, and the American Academy of Pediatrics recommends that youngsters be screened for it starting at 18 months. While there’s no cure, behavioral and other therapies are thought to work best when started very young.

Yet on average, U.S. children aren’t diagnosed until they’re about 4 1/2 years old, according to government statistics.

And troubling studies show that white kids may be diagnosed with autism as much as a year and a half earlier than black and other minority children, says University of Pennsylvania autism expert David Mandell, who led much of that work. Socioeconomics can play a role, if minority families have less access to health care or less education.

But Mandell says the full story is more complex. One of his own studies, for example, found that black children with autism were more likely than whites to get the wrong diagnosis during their first visit with a specialist.

http://www.huffingtonpost.com/2012/02/28/autism-not-diagnosed-as-early-in-minority-children_n_1306272.html

See, New Study Shows Minority Toddlers with Autism are More Delayed than Affected Caucasian Peers http://www.kennedykrieger.org/overview/news/new-study-shows-minority-toddlers-autism-are-more-delayed-affected-caucasian-peers

Citation:

Journal of Autism and Developmental Disorders

DOI: 10.1007/s10803-012-1445-8

Original Paper

Differences in Autism Symptoms Between Minority and Non-Minority Toddlers

Saime Tek and Rebecca J. Landa

The number of children with autism appears to be growing.

The Centers for Disease Control and Prevention provides statistics on the number of children with autism in the section Data and Statistics:

Prevalence

  • It is estimated that between 1 in 80 and 1 in 240 with an average of 1 in 110 children in the United States have an ASD. [Read article
  • ASDs are reported to occur in all racial, ethnic, and socioeconomic groups, yet are on average 4 to 5 times more likely to occur in boys than in girls.  However, we need more information on some less studied populations and regions around the world. [Read article]
  • Studies in Asia, Europe, and North America have identified individuals with an ASD with an approximate prevalence of 0.6% to over 1%. A recent study in South Korea reported a prevalence of 2.6%. [Data table Adobe PDF file]
  • Approximately 13% of children have a developmental disability, ranging from mild disabilities such as speech and language impairments to serious developmental disabilities, such as intellectual disabilities, cerebral palsy, and autism.  [Read articleExternal Web Site Icon]

Learn more about prevalence of ASDs »

Learn more about the ADDM Project »

Learn more about the MADDSP Project »

On this Page

http://www.cdc.gov/ncbddd/autism/data.html

In order for children with autism to reach their full potential there must be early diagnosis and treatment.

The National Institute of Neurological Disorders and Stroke has an autism fact sheet

What is autism?

Autism spectrum disorder (ASD) is a range of complex neurodevelopment disorders, characterized by social impairments, communication difficulties, and restricted, repetitive, and stereotyped patterns of behavior.  Autistic disorder, sometimes called autism or classical ASD, is the most severe form of ASD, while other conditions along the spectrum include a milder form known as Asperger syndrome, and childhood disintegrative disorder and pervasive developmental disorder not otherwise specified (usually referred to as PDD-NOS).  Although ASD varies significantly in character and severity, it occurs in all ethnic and socioeconomic groups and affects every age group.  Experts estimate that six children out of every 1,000 will have an ASD.  Males are four times more likely to have an ASD than females.

What are some common signs of autism?

The hallmark feature of ASD is impaired social interaction.  As early as infancy, a baby with ASD may be unresponsive to people or focus intently on one item to the exclusion of others for long periods of time.  A child with ASD may appear to develop normally and then withdraw and become indifferent to social engagement.

Children with an ASD may fail to respond to their names and often avoid eye contact with other people.  They have difficulty interpreting what others are thinking or feeling because they can’t understand social cues, such as tone of voice or facial expressions, and don’t watch other people’s faces for clues about appropriate behavior.  They lack empathy.

Many children with an ASD engage in repetitive movements such as rocking and twirling, or in self-abusive behavior such as biting or head-banging.  They also tend to start speaking later than other children and may refer to themselves by name instead of “I” or “me.”  Children with an ASD don’t know how to play interactively with other children.  Some speak in a sing-song voice about a narrow range of favorite topics, with little regard for the interests of the person to whom they are speaking.

Children with characteristics of an ASD may have co-occurring conditions, including Fragile X syndrome (which causes mental retardation), tuberous sclerosis, epileptic seizures, Tourette syndrome, learning disabilities, and attention deficit disorder.  About 20 to 30 percent of children with an ASD develop epilepsy by the time they reach adulthood. .

How is autism diagnosed?

ASD varies widely in severity and symptoms and may go unrecognized, especially in mildly affected children or when it is masked by more debilitating handicaps.  Very early indicators that require evaluation by an expert include:

  • no babbling or pointing by age 1
  • no single words by 16 months or two-word phrases by age 2
  • no response to name
  • loss of language or social skills
  • poor eye contact
  • excessive lining up of toys or objects
  • no smiling or social responsiveness.

Later indicators include:

  • impaired ability to make friends with peers
  • impaired ability to initiate or sustain a conversation with others
  • absence or impairment of imaginative and social play
  • stereotyped, repetitive, or unusual use of language
  • restricted patterns of interest that are abnormal in intensity or focus
  • preoccupation with certain objects or subjects
  • inflexible adherence to specific routines or rituals.

Health care providers will often use a questionnaire or other screening instrument to gather information about a child’s development and behavior.  Some screening instruments rely solely on parent observations, while others rely on a combination of parent and doctor observations.  If screening instruments indicate the possibility of an ASD, a more comprehensive evaluation is usually indicated….

What causes autism?

Scientists aren’t certain about what causes ASD, but it’s likely that both genetics and environment play a role.  Researchers have identified a number of genes associated with the disorder.  Studies of people with ASD have found irregularities in several regions of the brain.  Other studies suggest that people with ASD have abnormal levels of serotonin or other neurotransmitters in the brain.  These abnormalities suggest that ASD could result from the disruption of normal brain development early in fetal development caused by defects in genes that control brain growth and that regulate how brain cells communicate with each other, possibly due to the influence of environmental factors on gene function.  While these findings are intriguing, they are preliminary and require further study.  The theory that parental practices are responsible for ASD has long been disproved….

Parents must pay attention to whether their children are developing within the parameters of what is appropriate for the child’s age.

Resources:

For more information on neurological disorders or research programs funded by the National Institute of Neurological Disorders and Stroke, contact the Institute’s Brain Resources and Information Network (BRAIN) at:

BRAIN
P.O. Box 5801
Bethesda, MD 20824
(800) 352-9424
http://www.ninds.nih.gov

Association for Science in Autism Treatment
P.O. Box 188
Crosswicks, NJ   08515-0188
info@asatonline.org
http://www.asatonline.org

Autism National Committee (AUTCOM)
P.O. Box 429
Forest Knolls, CA   94933
http://www.autcom.org

Autism Network International (ANI)
P.O. Box 35448
Syracuse, NY   13235-5448
jisincla@syr.edu
http://www.ani.ac

Autism Research Institute (ARI)
4182 Adams Avenue
San Diego, CA   92116
director@autism.com
http://www.autismresearchinstitute.com
Tel: 866-366-3361
Fax: 619-563-6840

Autism Science Foundation
419 Lafayette Street
2nd floor
New York, NY   10003
contactus@autismsciencefoundation.org
http://www.autismsciencefoundation.org/
Tel: 646-723-3978
Fax: 212-228-3557

Autism Society of America
4340 East-West Highway
Suite 350
Bethesda, MD   20814
http://www.autism-society.org
Tel: 301-657-0881 800-3AUTISM (328-8476)
Fax: 301-657-0869

Autism Speaks, Inc.
2 Park Avenue
11th Floor
New York, NY   10016
contactus@autismspeaks.org
http://www.autismspeaks.org
Tel: 212-252-8584 California: 310-230-3568
Fax: 212-252-8676

Birth Defect Research for Children, Inc.
976 Lake Baldwin Lane
Suite 104
Orlando, FL   32814
betty@birthdefects.org
http://www.birthdefects.org
Tel: 407-895-0802

MAAP Services for Autism, Asperger Syndrome, and PDD
P.O. Box 524
Crown Point, IN   46308
info@aspergersyndrome.org
http://www.aspergersyndrome.org/
Tel: 219-662-1311
Fax: 219-662-1315

National Dissemination Center for Children with Disabilities
U.S. Dept. of Education, Office of Special Education Programs
1825 Connecticut Avenue NW, Suite 700
Washington, DC   20009
nichcy@aed.org
http://www.nichcy.org
Tel: 800-695-0285 202-884-8200
Fax: 202-884-8441

National Institute of Child Health and Human Development (NICHD)
National Institutes of Health, DHHS
31 Center Drive, Rm. 2A32 MSC 2425
Bethesda, MD   20892-2425
http://www.nichd.nih.gov
Tel: 301-496-5133
Fax: 301-496-7101

National Institute on Deafness and Other Communication Disorders Information Clearinghouse
1 Communication Avenue
Bethesda, MD   20892-3456
nidcdinfo@nidcd.nih.gov
http://www.nidcd.nih.gov
Tel: 800-241-1044 800-241-1055 (TTD/TTY)

National Institute of Environmental Health Sciences (NIEHS)
National Institutes of Health, DHHS
111 T.W. Alexander Drive
Research Triangle Park, NC   27709
webcenter@niehs.nih.gov
http://www.niehs.nih.gov
Tel: 919-541-3345

National Institute of Mental Health (NIMH)
National Institutes of Health, DHHS
6001 Executive Blvd. Rm. 8184, MSC 9663
Bethesda, MD   20892-9663
nimhinfo@nih.gov
http://www.nimh.nih.gov
Tel: 301-443-4513/866-415-8051 301-443-8431 (TTY)
Fax: 301-443-4279

“Autism Fact Sheet,” NINDS. Publication date September 2009.

NIH Publication No. 09-1877

Back to Autism Information Page

Dr. Wilda says this about that ©

Seattle Children’s Institute study: Supportive middle school teachers affect a kid’s alcohol use

26 Mar

Substance abuse is a serious problem for many young people. The Centers for Disease Control provide statistics about underage drinking in the Fact Sheet: Underage Drinking:

Underage Drinking

Alcohol use by persons under age 21 years is a major public health problem.1 Alcohol is the most commonly used and abused drug among youth in the United States, more than tobacco and illicit drugs. Although drinking by persons under the age of 21 is illegal, people aged 12 to 20 years drink 11% of all alcohol consumed in the United States.2 More than 90% of this alcohol is consumed in the form of binge drinks.2 On average, underage drinkers consume more drinks per drinking occasion than adult drinkers.3 In 2008, there were approximately 190,000 emergency rooms visits by persons under age 21 for injuries and other conditions linked to alcohol.4

Drinking Levels among Youth

The 2009 Youth Risk Behavior Survey5 found that among high school students, during the past 30 days

  • 42% drank some amount of alcohol.
  • 24% binge drank.
  • 10% drove after drinking alcohol.
  • 28% rode with a driver who had been drinking alcohol.

Other national surveys indicate

  • In 2008 the National Survey on Drug Use and HealthExternal Web Site Icon reported that 28% of youth aged 12 to 20 years drink alcohol and 19% reported binge drinking.6
  • In 2009, the Monitoring the Future SurveyExternal Web Site Icon reported that 37% of 8th graders and 72% of 12th graders had tried alcohol, and 15% of 8th graders and 44% of 12th graders drank during the past month.7

Consequences of Underage Drinking

Youth who drink alcohol1, 3, 8 are more likely to experience

  • School problems, such as higher absence and poor or failing grades.
  • Social problems, such as fighting and lack of participation in youth activities.
  • Legal problems, such as arrest for driving or physically hurting someone while drunk.
  • Physical problems, such as hangovers or illnesses.
  • Unwanted, unplanned, and unprotected sexual activity.
  • Disruption of normal growth and sexual development.
  • Physical and sexual assault.
  • Higher risk for suicide and homicide.
  • Alcohol-related car crashes and other unintentional injuries, such as burns, falls, and drowning.
  • Memory problems.
  • Abuse of other drugs.
  • Changes in brain development that may have life-long effects.
  • Death from alcohol poisoning.

In general, the risk of youth experiencing these problems is greater for those who binge drink than for those who do not binge drink.8

Youth who start drinking before age 15 years are five times more likely to develop alcohol dependence or abuse later in life than those who begin drinking at or after age 21 years.9, 10 http://www.cdc.gov/alcohol/fact-sheets/underage-drinking.htm

See, Alcohol Use Among Adolescents and Young Adults http://pubs.niaaa.nih.gov/publications/arh27-1/79-86.htm

Seattle Children’s Institute has just published the the study, “Emotional Health Predictors of Substance Use Initiation During Middle School,” was published in advance online in Psychology of Addictive Behaviors. Here is the press release from Seattle Children’s Institute:

Middle School Teacher Support Lowers Risk for Early Alcohol Use

March 21, 2012

Youth with parental separation anxiety also at decreased risk

Anxiety, depression, stress and social support can predict early alcohol and illicit drug use in youth, according to a study from Carolyn McCarty, PhD, of Seattle Children’s Research Institute, and researchers from the University of Washington and Seattle University.  Middle school students from the sixth to the eighth grade who felt more emotional support from teachers reported a delay in alcohol and other illicit substance initiation. Those who reported higher levels of separation anxiety from their parents were also at decreased risk for early alcohol use. The study, “Emotional Health Predictors of Substance Use Initiation During Middle School,” was published in advance online in Psychology of Addictive Behaviors.

Relatively few studies have examined support for youth from nonfamily members of the adolescent’s social support network, including teachers. “Our results were surprising,” said Dr. McCarty, who is also a University of Washington research associate professor.  “We have known that middle school teachers are important in the lives of young people, but this is the first data-driven study which shows that teacher support is associated with lower levels of early alcohol use.”  Middle school students defined teacher support as feeling close to a teacher or being able to talk with a teacher about problems they are experiencing.

Youth that are close to or even cling to parents can have separation anxiety and may be less susceptible to negative influences from peers, including experimentation with risky behaviors like alcohol use.  “Teens in general seek new sensations or experiences and they take more risks when they are with peers,” said Dr. McCarty.  “Youth with separation anxiety symptoms may be protected by virtue of their intense connection to their parents, making them less likely to be in settings where substance use initiation is possible,” she said.

The study also found that youth who initiated alcohol and other illicit drug use prior to sixth grade had significantly higher levels of depressive symptoms.  This suggests that depression may be a consequence of very early use or a risk factor for initiation of use prior to the middle school years.  Depression was defined by asking youth about their mood and feelings, and asking them if statements such as “I felt awful or unhappy” and “I felt grumpy or upset with my parents” were true, false or sometimes true during a two-week timeframe. 

Based on the study and our findings, substance use prevention needs to be addressed on a multidimensional level,” said Dr. McCarty.  “We need to be aware of and monitor early adolescent stress levels, and parents, teachers and adults need to tune into kids’ mental health.  We know that youth who initiate substance abuse before age 14 are at a high risk of long-term substance abuse problems and myriad health complications.” 

Dr. McCarty Offers Tips for Parents to Help Reduce Early Alcohol Use 

  • Know where your child is, and check in with your child on a regular basis 
  • Get to know your child’s friends, and who your child spends time with 
  • Teach stress management skills 
  • Help your child feel connected with adults at school  

Dr. McCarty and the research team analyzed data from the Developmental Pathways Project, a longitudinal study of 521 youth sampled from the Seattle Public Schools.  Researchers analyzed the effects of depression, anxiety, stress and support on initiation of substance use, which was measured at five different time points between sixth and eighth grade.

Seattle Children’s Research Institute, in collaboration with the University of Washington and Seattle University, will continue to study this topic, next looking at the timing between youth substance use and depression, as well as how intervention programs for depression impact substance use.

Dr. McCarty’s co-authors were:  Elizabeth McCauley, PhD, Seattle Children’s Research Institute, University of Washington; Elise Murowchick, PhD, Seattle University; Isaac Rhew, PhD, University of Washington; and Ann Vander Stoep, PhD, University of Washington.

Supporting Materials: 

http://www.seattlechildrens.org/Press-Releases/2012/Middle-School-Teacher-Support-Lowers-Risk-for-Early-Alcohol-Use/

Assuming you are not one of those ill-advised parents who supply their child with alcohol or drugs like marijuana in an attempt to be hip or cool, suspicions that your child may have a substance abuse problem are a concern. Confirmation that your child has a substance abuse problem can be heartbreaking. Even children whose parents have seemingly done everything right can become involved with drugs. The best defense is knowledge about your child, your child’s friends, and your child’s activities. You need to be aware of what is influencing your child.

Our goal should be:

A Healthy Child In A Healthy Family Who Attends A Healthy School In A Healthy Neighborhood. ©

Related:

New study about substance abuse and kids https://drwilda.wordpress.com/2011/11/09/new-study-about-substance-abuse-and-kids/

Dr. Wilda says this about that ©

Teaching kids that babies are not delivered by UPS

22 Jan

It is time for some speak the truth, get down discussion. An acquaintance who practices family law told me this story about paternity. A young man left Seattle one summer to fish in Alaska. He worked on a processing boat with 30 or40 others. He had sex with this young woman. He returned to Seattle and then got a call from her saying she was pregnant. He had been raised in a responsible home and wanted to do the right thing for this child. His mother intervened and demanded a paternity test. To make a long story, short. He wasn’t the father. In the process of looking out for this kid’s interests, my acquaintance had all the men on the boat tested and none of the other “partners” was the father. Any man that doesn’t have a paternity test is a fool.

If you are a slut, doesn’t matter whether you are a male or female you probably shouldn’t be a parent.

How to tell if you are a slut?

  1. If you are a woman and your sex life is like the Jack in the Box 24-hour drive through, always open and available. Girlfriend, you’re a slut.
  1. If you are a guy and you have more hoes than Swiss cheese has holes. Dude, you need to get tested for just about everything and you are a slut. 

Humans have free will and are allowed to choose how they want to live. What you do not have the right to do is to inflict your lifestyle on a child. So, the responsible thing for you to do is go to Planned Parenthood or some other outlet and get birth control for yourself and the society which will have to live with your poor choices. Many religious folks are shocked because I am mentioning birth control, but most sluts have few religious inklings or they wouldn’t be sluts. A better option for both sexes, if this lifestyle is a permanent option, is permanent birth control to lessen a contraception failure. People absolutely have the right to choose their particular lifestyle. You simply have no right to bring a child into your mess of a life. I observe people all the time and I have yet to observe a really happy slut. Seems that the lifestyle is devoid of true emotional connection and is empty. If you do find yourself pregnant, please consider adoption.

Let’s continue the discussion. Some folks may be great friends, homies, girlfriends, and dudes, but they make lousy parents. Could be they are at a point in their life where they are too selfish to think of anyone other than themselves, they could be busy with school, work, or whatever. No matter the reason, they are not ready and should not be parents. Birth control methods are not 100% effective, but the available options are 100% ineffective in people who are sexually active and not using birth control. So, if you are sexually active and you have not paid a visit to Planned Parenthood or some other agency, then you are not only irresponsible, you are Eeeevil. Why do I say that, you are playing Russian Roulette with the life of another human being, the child. You should not ever put yourself in the position of bringing a child into the world that you are unprepared to parent, emotionally, financially, and with a commitment of time. So, if you find yourself in a what do I do moment and are pregnant, you should consider adoption.

Why the rant? Live Science reports in the article, 1 in 6 Teen Moms Say They Didn’t Believe They Could Get Pregnant:

Half of teen mothers say they were not using birth control when they got pregnant, and a new report outlines the reasons teens give for not doing so.

Of teen moms who reported not using birth control, 31 percent said they did not believe they could get pregnant at the time. To decrease teen birth rates, teens need factual information about the conditions under which pregnancy can occur, along with public health efforts aimed at reducing or delaying teens’ sexual activities, according to the report released today by researchers for the Centers for Disease and Control and Prevention.

Others gave various reasons for not using birth control — 24 percent said their partner did not want to use contraception, 13 percent said they had trouble getting birth control, 9 percent said they experienced side effects from using contraception and 8 percent said they thought their sex partner was sterile. Twenty-two percent of the teens said they did not mind getting pregnant.

Health care providers and parents can work to prevent teen pregnancy by increasing teens’ motivation to avoid pregnancy; providing access to contraception and encouraging the use of more effective methods, and strengthening the skills of teens to negotiate contraceptive use with their partners….

Research has shown that teens who report using birth control do not use it consistently, the report noted. One survey found that among sexually active teens who reported using condoms, only 52 percent said they used a condom every time they had sex.

The rates of not using birth control did not vary among teens of different racial groups — whether white, black or Hispanic, about half the teens reported not using birth control when they became pregnant.

There were some differences among the groups in terms of the reasons teens gave for not using birth control. Forty-two percent of Hispanic teens reported not using contraception because they did not think they could get pregnant at the time, whereas 32 percent of black teens gave that reason and 27 percent of white teens did.

Previous research has shown that 17 percent of all sexually active teens report not using birth control when they last had sex….

About 400,000 U.S. teens ages 15 to 19 give birth each year, which gives the United States the highest teen birth rate in the developed world, according to the report.

Teen mothers are more likely than others to drop out of school, and infants born to teens are more likely to have low birth weight, putting them at risk for a number of health conditions, and lower academic achievement, according to the report.
http://news.yahoo.com/1-6-teen-moms-didnt-believe-could-pregnant-202403188.html

Parents and guardians must have age-appropriate conversations with their children and communicate not only their values, but information about sex and the risks of sexual activity.

The Centers for Disease Control and Prevention has a plethora of information about Sexually Transmitted Diseases (STDs).

19 Million

STDs are one of the most critical health challenges facing the nation today. CDC estimates that there are 19 million new infections every year in the United States.

$17 Billion

STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences.

CDC’s surveillance report includes data on the three STDs that physicians are required to report to local or state public health authorities—gonorrhea, chlamydia, and syphilis—which represent only a fraction of the true burden of STDs. Some common STDs, like human papillomavirus (HPV) and genital herpes, are not required to be reported.

The latest CDC data show troubling trends in three treatable STDs:

  • Gonorrhea: While reported rates are at historically low levels, cases increased slightly from last year and more than 300,000 cases were reported in 2010. There are also signs from other CDC surveillance systems that the disease may become resistant to the only available treatment option.
  • Chlamydia: Case reports have been increasing steadily over the past 20 years, and in 2010, 1.3 million chlamydia cases were reported. While the increase is due to expanded screening efforts, and not to an actual increase in the number of people with chlamydia, a majority of infections still go undiagnosed. Less than half of sexually active young women are screened annually as recommended by CDC.
  • Syphilis: The overall syphilis rate decreased for the first time in a decade, and is down 1.6 percent since 2009. However, the rate among young black men has increased dramatically over the past five years (134 percent). Other CDC data also show a significant increase in syphilis among young black men who have sex with men (MSM), suggesting that new infections among MSM are driving the increase in young black men. The finding is particularly concerning as there has also been a sharp increase in HIV infections among this population.

For more detailed data on each disease, see the Snapshot and Table.

Less than half of people who should be screened receive recommended STD screening services

Undetected and untreated STDs can increase a person’s risk for HIV and cause other serious health consequences, such as infertility. STD screening can help detect disease early and, when combined with treatment, is one of the most effective tools available to protect one’s health and prevent the spread of STDs to others.

STDs in the United States: A Look Beyond the Data

STDs primarily affect young people, but the health consequences can last a lifetime

Young people represent 25 percent of the sexually experienced population in the United States, but account for nearly half of new STDs. The long-lasting health effects are particularly serious for young people:

  • Untreated gonorrhea and chlamydia can silently steal a young woman’s chance to have her own children later in life. Each year, untreated STDs cause at least 24,000 women in the U.S. to become infertile.
  • Untreated syphilis can lead to serious long-term complications, including brain, cardiovascular, and organ damage. Syphilis in pregnant women can also result in congenital syphilis (syphilis among infants), which can cause stillbirth, death soon after birth, and physical deformity and neurological complications in children who survive. Untreated syphilis in pregnant women results in infant death in up to 40 percent of cases.
  • Studies suggest that people with gonorrhea, chlamydia, or syphilis are at increased risk for HIV. Given the increase in both syphilis and HIV among young black gay and bisexual men, it is particularly urgent to diagnose and treat both diseases.

A range of factors place some populations at greater risk for STDs

STDs affect people of all races, ages, and sexual orientations, though some individuals experience greater challenges in protecting their health. When individual risk behaviors are combined with barriers to quality health information and STD prevention services, the risk of infection increases. While everyone should have the opportunity to make choices that allow them to live healthy lives regardless of their income, education, or racial/ethnic background, the reality is that if an individual lacks resources or has difficult living conditions, the journey to health and wellness can be harder. Even with similar levels of individual risk, African Americans and Latinos sometimes face barriers that contribute to increased rates of STDs and are more affected by these diseases than whites.                                   http://www.cdc.gov/std/stats10/trends.htm                                                                                                 See, Sexually Transmitted Diseases (STDs) http://www.emedicinehealth.com/sexually_transmitted_diseases/article_em.htm

Lisa Frederiksen has written the excellent article, 10 Tips for Talking to Teens About Sex, Drugs & Alcohol which was posted at the Partnership for A Drug-Free America

1. Talk early and talk often about sex. “Teens are thinking about sex from early adolescence and they’re very nervous about it,” explains Elizabeth Schroeder, EdD, MSW, Executive Director, Answer, a national sexuality education organization based at Rutgers University.  “They get a lot of misinformation about sex and what it’s supposed to be like. And as a result they think that if they take drugs, if they drink, that’s going to make them feel less nervous.”

Take this quiz to sharpen your talking skills.

2. Take a moment. What if your teen asks a question that shocks you? Dr. Schroeder suggests saying, “‘You know, that’s a great question.‘ or ‘I gotta tell you, I’m not sure if you’re being serious right now but I need a minute.‘” Then regain your composure and return to the conversation.

Learn how to handle personal questions from your teen like: “How old were you when you first had sex?” and “Have you ever used drugs?”

3. Be the source of accurate information. Beyond many school health classes, teens have lots of questions about drugs, pregnancy, condoms, abstinence and oral sex.

Find out what one mom discovered when she sat in on her daughter’s sex ed class.

4. Explain the consequences. Since teen brains aren’t wired yet for consequential thinking and impulse control, it’s important to have frank discussions with your teens about the ramifications of unprotected sex and the importance of using condoms to prevent the spread of STDs, HIV and unwanted pregnancy.

Find out how to guide your child toward healthy risks instead of dangerous ones.

5. Help your child figure out what’s right and wrong. Teens need — and want– limits.  When it comes to things like sexuality, drugs and alcohol, they want to know what the rules and consequences are.

6. Use teachable moments. Watch TV shows (like “16 and Pregnant,”  “Teen Mom,” “Jersey Shore” and “Greek”), movies, commercials, magazine ads and the news with your teen and ask “What did you think about that?” “What did you notice about how these characters interacted?”  “What did you think about the decisions they made?” For us, one of the best ways to talk about a number of heavy topics was to take a drive — that way we weren’t face-to-face.

7.  Explain yourself. Teens need to hear your rationale and why you feel the way you do. One approach is to talk about sex, drugs and alcohol in the context of your family’s values and beliefs.

One of the most challenging moments for me was when my daughters brought up the subject of intercourse.  I explained that my hope was they would not do it until they were in a committed, mutually caring relationship and that it would be a choice, not an attempt to hold onto a relationship and that it would be mutually satisfying.

8. Talk about “sexting.” Texting sexual images and messages is more prevalent than you may think. Read more.

9. Remember how you felt. I know when I started puberty I had many thoughts, feelings and questions that weren’t discussed in my family. Things like body changes, feelings of attraction, acne, weight gain, emotional confusion and the desire to push your parents away.  I wanted to help my daughters avoid that confusion.  I wanted them to understand early on that puberty is a hardwired, biological change that happens to all humans so they become interested in sex for the purposes of procreation. It’s natural to have impulses and feelings that are part and parcel to puberty. Teens don’t have control over these feelings and impulses, but they do have control over whether they act on them.

10. Persevere. Dr. Schroeder warns that your teenager may not want to talk — he or she may shrug and walk away. “Adolescents are supposed to behave in that way when inside what they’re really saying is ‘Keep talking to me about this. I need to know what you think. I’m trying to figure this out for myself as a teenager and if I don’t get messages from you, then I’m not going to know how to do this,’” she explains.

Parents not only have the right, but the duty to communicate their values to their children.

Dr. Wilda says this about that ©